Сlinical and economic evaluation of various etiotropic chemotherapy regimens in patients with respiratory tuberculosis with multidrug and extensively drug resistance

Objective : analysis of clinical and economic efficiency various etiotropic chemotherapy regimes in patients with respiratory tuberculosis multidrug- extensively drug-resistant (MDR XDR) pathogen using the pharmacoeconomic modeling method (Markov model). Material methods . A single-centre, observational, retrospective, cohort study was performed, which included who received treatment clinics affiliated organizations main Moscow institution during 2014–2019 regarding MDR/XDR pathogen. The data 1387 were analysed, 1093 “optimized basic regimen” (OBR) accordance Federal Clinical Recommendations 2015, 294 therapy recommendations World Health Organization 2018–2019. To evaluate efficiency, costeffectiveness used. When assessing costs treatment, direct (medical non-medical) taken into account. Results results showed that 68.4% group bedaquiline-containing regimens reached outcome “treatment successfully completed” (patient cured or transfered III dispensary follow-up) compared to 51.8% OBR group. use “new” is most economically justified ХDR-tuberculosis repeated courses: incremental cost-effectiveness ratios (ICER) 24,530.20 21,526.50 rubles per 1 patient. Markov model developed, transitions from one state another evaluated according observations first 2 years research. Conclusion dynamic patient made it possible refine estimates effectiveness for Based on dynamics interval 10 provides a significant increase proportion success (by 16.1–29.8% different groups at times), decrease mortality 6.1–11.0%), those interrupted 8.0–21.8%) comparison OBR.